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A case of recurrent cholangitis after bile duct injury during laparoscopic cholecystectomy: Value of scintigraphy with Tc-99m GSA and hepatobiliary scintigraphy for indication of lobectomy

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Abstract

A 39-year-old woman with acute cholecystitis and gallstones underwent laparoscopic cholecystectomy. She suffered from recurrent episodes of cholangitis due to injury of the major bile ducts during laparoscopic cholecystectomy.

Hepatobiliary scintigraphy with Tc-99m Sn-N-pyridoxyl-5-methyltryptophan was performed. Although normal bile excretion was found from the left hepatic duct to the percutaneous transhepatic biliary drainage (PTBD) tube, excretion from the right hepatic lobe was prolonged. Scintigraphy with Tc-99m diethylenetriaminepentaacetic acid-galactosyl human serum albumin demonstrated atrophy of the right hepatic lobe and enlargement of the left hepatic lobe. Cholangiography via the PTBD tube revealed complete obstruction of the left hepatico-jejunal anastomosis and could not enhance the right intrahepatic bile duct. A right hepatic lobectomy was performed because of the atrophy, glissonitis and the absence of an appropriate bile duct for reconstruction. Postoperatively she was active and exhibited no evidence of recurrent cholangitis.

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Authors and Affiliations

  1. Third Department of Internal Medicine, Osaka City University Medical School, 1-4-3 Asahimachi, Abeno-ku, 545-8585, Osaka, Japan

    Shuhei Nishiguchi, Susumu Shiomi, Nobumitsu Sasaki & Yoshinori Iwata

  2. Second Department of Surgery, Osaka City University Medical School, 1-4-3 Asahimachi, Abeno-ku, 545-8585, Osaka, Japan

    Hiromu Tanaka, Shoji Kubo & Kazuhiro Hirohashi

  3. Division of Nuclear Medicine, Osaka City University Medical School, 1-4-3 Asahimachi, Abeno-ku, 545-8585, Osaka, Japan

    Hironobu Ochi

Authors
  1. Shuhei Nishiguchi
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  2. Susumu Shiomi
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  3. Nobumitsu Sasaki
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  4. Yoshinori Iwata
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  5. Hiromu Tanaka
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  6. Shoji Kubo
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  7. Kazuhiro Hirohashi
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  8. Hironobu Ochi
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Correspondence to Susumu Shiomi.

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Nishiguchi, S., Shiomi, S., Sasaki, N. et al. A case of recurrent cholangitis after bile duct injury during laparoscopic cholecystectomy: Value of scintigraphy with Tc-99m GSA and hepatobiliary scintigraphy for indication of lobectomy. Ann Nucl Med 14, 383–386 (2000). https://doi.org/10.1007/BF02988702

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  • DOI: https://doi.org/10.1007/BF02988702

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